Mixed Results
End of the 51st Cycle of Pomalidomide (CC-4047):
As often happens, some of the myeloma blood markers are up this month, some down. M-Spike is down from 1.2 to 1.1 g/dL, but IgG is up from 1190 to 1280 mg/dL. I don't know which to believe, so I'm calling it a draw, meaning "stable" in cancer lingo. For good measure, Lambda light chains are down from 2.24 to 1.99 mg/dL, while Kappa chains went up, making the ratio go up, which in my case is good. I think. Maybe. As Dr L said, "We'll take it."
I take a little capsule containing 2 mg of pomalidomide every night, and every 28 days my family and I drive the 80 miles to Mayo Clinic in Rochester, where I have blood tests and the occasional ECG or X-ray. Next month will mark four full years on the pomalidomide study. I'm a satisfied customer!
Some of the discussion with Dr. L:
- A previous doc at Mayo had given me a prescription for bactrim, an antibiotic, to be taken daily to ward off a pneumonia which attacks people with compromised immune systems. Dr. L gives the same prescription for people in my situation when dexamethasone (DEX) is part of the regimen, but not otherwise, and I am no longer taking DEX, so she did not renew the prescription. OK, the fewer medications the better.
- I mentioned to Dr. L that the neuropathy in my fingers is slowly advancing. For example, I recently felt a suspicious blueberry between thumb and forefinger to see if it was soft or firm, but I couldn't tell without picking it up to check it more closely. She asked if I had tried acupuncture, and remarked that a few of her other patients seemed to have some success with it. I might try it, but right now the neuropathy doesn't really affect my quality of life. Yet.
- Calcium was up again, slightly above the reference level. Dr. L thought it might be due to slight dehydration, especially since my blood draw was at 10 am rather than the usual 6 am and I can't take fluids until the blood draw. I think that's probably right. Anyway I have a skeletal survey and a bone density test scheduled for next month, so if the calcium is an indicator of bone loss, there is a pretty good chance of catching it.
Peripheral Neuropathy (PN):
The International Myeloma Working Group (IMWG) recently issued Guidelines for the Management of Treatment-Emergent Peripheral Neuropathy in Multiple Myeloma. This is a very comprehensive document which I recommend to anyone dealing with neuropathy caused by myeloma treatments. It discusses drugs, supplements, physical therapy, acupuncture, chemotherapy dose modification, and even prevention of PN. It's a guide for both doctors and patients.
If that link doesn't work, use this one, a verbatim copy of just the document, on another web site.
Some Recent Test Results:
| Test
|
| Nov 17
|
| Dec 14
|
| Jan 12
|
| Feb 07
|
| Remarks
|
| M-spike g/dL
| | 1.1
| | 1.1
| | 1.2
| | 1.1
| | \ Tumor marker
|
| IgG mg/dL
| | 1280
| | 999
| | 1190
| | 1280
| | / Tumor marker
|
| Lambda mg/dL
| | 2.12
| | 3.15
| | 2.24
| | 1.99
| | L Free light chains
|
| Calcium mg/dL
| | 10.3
| | 10.3
| | 10.0
| | 10.2
| | High
|
| Creatinine mg/dL
| | 1.1
| | 1.1
| | 1.0
| | 1.0
| | Kidney, OK
|
| HGB g/dL
| | 15.0
| | 15.1
| | 15.1
| | 15.2
| | Hemoglobin, OK
|
| RBC M/uL
| | 4.18
| | 4.17
| | 4.36
| | 4.18
| | Red cells, low
|
| WBC K/uL
| | 5.3
| | 4.8
| | 4.8
| | 4.5
| | White cells, normal
|
| ANC K/uL
| | 1.70
| | 1.90
| | 2.40
| | 1.70
| | Neutrophils, normal
|
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